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General Practice 2023

Renal Tubular Acidosis: what é, symptoms and treatment

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Renal Tubular Acidosis: what é, symptoms and treatment
Renal Tubular Acidosis: what é, symptoms and treatment

Renal Tubular Acidosis, or RTA, is an alteration related to the process of renal tubular reabsorption of bicarbonate or hydrogen excretion in the urine, resulting in an increase in the body's pH known as acidosis, which can result in a delay in children's growth, difficulty gaining weight, muscle weakness and decreased reflexes, for example.

It is important that RTA is identified and treated quickly by taking bicarbonate as recommended by the doctor to avoid complications such as osteoporosis and loss of kidney function, for example.

How to identify Tubular Renal Acidosis

Tubular Renal Acidosis is often asymptomatic, however as the disease progresses, some symptoms may appear, especially if there is no maturation of the excretory system.It is possible to suspect ART in children when it is not possible to perceive correct growth or weight gain, and it is important to take the child to the pediatrician for diagnosis and treatment to be started.

The main indicative signs of Tubular Renal Acidosis are:

  • Development delay;
  • Difficulty for child to gain weight;
  • Nausea and vomiting;
  • Appearance of kidney stone;
  • Gastrointestinal changes, possibly constipation or diarrhea;
  • Muscle weakness;
  • Decreased reflections;
  • Language development delay.

Children diagnosed with ART can have a completely normal life and quality of life as long as they are treated correctly to avoid complications. However, it is possible that they become more susceptible to infections due to the greater fragility of the immune system.

In some cases, the symptoms of Tubular Renal Acidosis may disappear between 7 and 10 years of age due to the maturation of the kidneys, with no need for treatment, only medical follow-up to assess whether the kidneys are, in fact, working properly..

Cause and diagnosis of ART

Tubular Renal Acidosis can happen due to genetic and hereditary alterations, in which the person is born with alteration in the transport process of the renal tubules, being classified as primary, or due to adverse drug effects, immaturity of the kidneys at birth or as a consequence of other diseases, such as diabetes, sickle cell disease or lupus, for example, in which kidney changes occur over time.

The diagnosis of ART is made based on the person's symptoms and blood and urine tests. In the blood test, the concentration of bicarbonate, chloride, sodium and potassium is evaluated, while in the urine it is mainly seen the concentration of bicarbonate and hydrogen.

In addition, an ultrasound of the kidneys may be indicated, to check for the presence of kidney stones, or X-ray of the hands or feet, for example, so that the doctor can check for bone changes that can interfere with the child's development.

How the treatment is done

Treatment of Tubular Renal Acidosis is carried out according to the guidance of a nephrologist or pediatrician, in the case of children, and involves taking bicarbonate daily in an attempt to reduce acidosis both in the body and in the urine, improving the body functioning.

Although it is a simple treatment, it can be quite aggressive to the stomach, which can result in gastritis, for example, causing discomfort to the person.

It is important that the treatment is carried out according to the doctor's recommendation to avoid the occurrence of complications related to excess acid in the body, such as bone deformation, appearance of kidney calcifications and kidney failure, for example.

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